Adjunctive memantine reduces agitation in Alzheimer's disease

Memantine plus cholinesterase inhibitors reduced agitation, delusion and other behavioral symptoms in individuals with Alzheimer’s disease, according to data presented at the American Academy of Neurology annual meeting.

“Agitation, a common, problematic neuropsychiatric symptom associated with Alzheimer’s disease, can increase caregiver burden and costs. Memantine and its extended-release formulation are approved for moderate-to-severe Alzheimer’s disease; cholinesterase inhibitors are additionally approved in mild Alzheimer’s disease,” Alireza Atri, MD, PhD, of Brigham and Women’s Hospital and Harvard Medical School, and colleagues wrote.

To determine efficacy of adjunctive memantine with cholinesterase inhibitors for agitation and other neuropsychiatric symptoms in Alzheimer’s disease, researchers pooled data from three phase 3, randomized, double-blind, placebo-controlled 24-week trials among individuals with moderate-to-severe or mild-to-moderate Alzheimer’s disease. Study participants received concurrent cholinesterase inhibitors.

Overall, 532 of 1,140 participants had symptomatic agitation. Of these, 263 participants received memantine plus cholinesterase inhibitors and 269 received placebo plus cholinesterase inhibitors.

Memantine plus cholinesterase inhibitors improved agitation at weeks 12 (P = .0003) and 24 (P = .0001), compared with placebo.

Participants who received memantine plus cholinesterase inhibitors exhibited improved Neuropsychiatric Inventory scores for delusion (P = .0217; P = .0365), irritability/lability (P = .0001; P = .0013), and total scores (P = .0003; P .0004) at weeks 12 and 24.

Neuropsychiatric Inventory scores also improved for delusion and irritability/lability among caregivers of participants who received memantine plus cholinesterase inhibitors.

“Memantine added to cholinesterase inhibitors may substantially reduce agitation and other behavioral disturbances in Alzheimer’s disease patients who experience agitation, and also may reduce caregiver burden related to these symptoms,” the researchers concluded. – by Amanda Oldt

Reference:

Atri A, et al. Memantine added to background cholinesterase-inhibitors reduces agitation and neuropsychiatric symptoms in Alzheimer’s disease. Presented at: American Academy of Neurology Annual Meeting; April 22-28, 2017; Boston.

Disclosure: The study was supported by Allergan.